When news broke out about the death of John Travolta's 16-year-old son Jett after hitting his head on the bathtub, toilet seat, or both on January 2, and after reports that the young Travolta had a history of seizures, searches on "Kawasaki disease" on the Internet skyrocketed as people picked up on reports that Jett had suffered from the disease when he was two years old.
Kawasaki disease is an illness predominantly among young children, with 80% of under age 5. Children over age 8 are rarely affected. The disease occurs more often among boys (over 60 percent) and among those of Asian ancestry. However, it can occur in every racial and ethnic group. In the US, over 4,000 cases of Kawasaki disease are being diagnosed annually and only less than 1 percent of those who get it die.
Kawasaki disease can cause persistent high fever that can last 5 days or longer. Usually, children who have it also have at least 4 of the following symptoms:
• A red, patchy rash that may cover the whole body;
• Swollen lymph nodes in the neck;
• Swollen and red hands and feet and, later in the illness, peeling skin on the fingers and toes;
• Changes in the lips and mouth, such as red, cracked lips, a very red tongue and redness in the mouth and the back of the throat; or
• Red, bloodshot eyes.
No one knows what causes Kawasaki disease, but it doesn't seem to be hereditary or contagious. Some doctors think it may be caused by a virus or bacteria. The illness can last from 2 weeks to a few months. Most children with Kawasaki disease get well with no complications, but in some cases, it may lead to heart or joint problems.
In 20 to 40 percent of the children with Kawasaki disease, the heart is affected and the coronary arteries or the heart muscle can be damaged (arrhythmia). Part of a coronary wall can be weakened and bulge out or balloon in an aneurysm. A blood clot can form in this weakened area and block the artery, sometimes leading to a heart attack. The aneurysm can also burst, but this rarely happens.
Other changes include inflammation of the heart muscle (myocarditis) or the sac surrounding the heart (pericarditis). Arrhythmias (abnormal heart rhythms) or abnormal functioning of some heart valves also can occur.
Usually all the heart problems go away in five or six weeks, and there will be no lasting damage. But sometimes coronary artery damage persists.
An arrhythmia can be detected using an electrocardiogram (EKG) while possible damage to the heart arteries can be seen through an echocardiogram (or "echo").
Meanwhile, Kawasaki disease can cause problems like swelling in the child's joints, but these problems usually go away without special treatment. Early diagnosis and treatment of the disease can prevent lasting heart or joint problems.
Treatment may consist of high doses of aspirin to lower the fever, control the rash, relieve joint pain and prevent blood clots. Immunoglobulin injections may also be given to help prevent heart problems.